An address on the treatment of wounds in war : delivered before the Medical Society of London on November 16, 1914 / by Sir W. Watson Cheyne.

  • Cheyne, William Watson, Sir, 1852-1932.
Date:
1914
Catalogue details

Licence: In copyright

Credit: An address on the treatment of wounds in war : delivered before the Medical Society of London on November 16, 1914 / by Sir W. Watson Cheyne. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Eradication of Sepsis. Now it is evident that the only efficient way of dealing with such a state of matters is to destroy these organisms, which have entered the wound, as soon as possible and before they have had time to grow and establish them- selves firmly in the tissues, bearing in mind the fact that every hour that passes they quadruple their numbers at the very least. This will not be done by painting a little iodine over the skin around, or even by pushing it in among the blood, and by covering the wound with a piece of aseptic gauze; very much more careful and vigorous treatment is required than that. And it should be in the mind of every man who deals with these wounds that the ultimate results depend to a large extent on the prevention of sepsis ; these results concerning not only the life of the patient, but also the rapidity and smoothness of his convalescence and his later condition. As to the period of time during which it is advisable to attempt disinfection of the wound, my opinion is that it is only during the first twenty-four hours that it is at all likely that bacteria can be eradicated, and indeed after twelve hours the result is not at all certain. During the first twelve hours, however, the great majority of wounds, unless they are large and irregular or complicated with extensive comminution of bone, can be quite readily and immedi- ately rendered aseptic, and if proper precautions are taken afterwards will remain aseptic, and thus the whole troubles resulting from the primary soiling of the wound will be avoided. Even up to twenty-four hours the infection can be rooted out in a considerable percentage of the cases- In the circumstances under consideration where wounds are soiled with earth, and where therefore there is con- siderable danger of tetanus and gangrene, I think that the period during which an attempt at disinfection should be made might be prolonged up to forty-eight hours. After that time the disinfection will certainly fail, and the attempt will do more harm than good by injuring the